Romney distances self from Mass. health plan

By Rick Klein, Globe Staff | February 3, 2007

BALTIMORE — With signs emerging that his signature healthcare plan faces hurdles, former governor Mitt Romney has begun to distance himself from the new law and is suggesting that Democrats will be to blame if the plan falters.

Yesterday, after addressing a gathering of conservative lawmakers in Baltimore, Romney told reporters that he cannot be held responsible for decisions that Beacon Hill lawmakers make about the sweeping plan now that he is out of office.

“I hope they take action that makes it work even better than I could have thought of,” said Romney, who is exploring a campaign for the 2008 Republican presidential nomination. “But if they take action that makes it unworkable, I’ll point that out. I’m not going to sit on the sidelines and not have a comment to make.”

At recent political appearances, Romney has subtly lowered expectations for the law he championed as governor. At the Dartmouth-Hitchcock Medical Center in New Hampshire on Thursday, he warned that the Democrat-dominated Massachusetts Legislature may cause the collapse of a system he helped design.

Concerned parents across the U.S. are leading a nationwide revolt against unnecessary, untested and dangerous vaccines as CDC records show a growing amount of religious exemptions on vaccine forms, following a media blitz by Jenny McCarthy in which she blamed a vaccine for causing her son’s autism.

Far from the biased and prejudiced context in which the Associated Press headline framed it – ‘Parents take a shot at lying on vaccine forms’ – the move comes as a result of increased understanding and education about the dangers of vaccines.

Most recently, actress and model Jenny McCarthy’s appearance on the Oprah Winfrey show and numerous other prime time TV programs has spurred women to seriously investigate the link between autism in babies and young children and vaccinations.

The Anti-Family Planning Czar

On Monday, President Bush appointed Susan Orr Acting Deputy Assistant Secretary for Population Affairs at the Department of Health and Human Services (HHS), a position that gives her oversight of federal family planning programs. Orr, who is currently directing HHS child welfare programs, was touted by the administration as “highly qualified.” Before joining HHS, Orr served as senior director for marriage and family care at the conservative Family Research Council, which opposes family planning, and was an adjunct professor at Pat Robertson’s Regent University. In her new role, Orr, who considers contraceptives part of the “culture of death,” will be responsible for “HHS’s $283 million reproductive-health program, a $30 million program that encourages abstinence among teenagers, and HHS’s Office of Population Affairs, which funds birth control, pregnancy tests, counseling, and screenings for sexually transmitted diseases and HIV.” Given Orr’s record of opposition to comprehensive family planning services, women’s rights and reproductive health advocates are speaking out strongly against her appointment. “We are appalled,” said Mary Jane Gallagher, president of the National Family Planning and Reproductive Health Association. “While her resume suggests a commitment to child welfare and children, her professional credentials fail to demonstrate a commitment to comprehensive family planning services for all men and women in need.” Rep. Henry Waxman (D-CA) called her appointment “absurd.” Referring to her as “a virulently anti-family planning radical,” Planned Parenthood has circulated a petition opposing Orr. Unfortunately, though, appointing Orr as an “acting” secretary allows the administration to sidestep the need for Senate confirmation.

BUSH’S PATTERN OF RADICAL APPOINTMENTS: Orr is the latest in a long line of Bush administration appointments promoting “a conservative political agenda” that often “runs counter to well-established science.” In 2002, Bush appointed W. David Hager, an obstetrician-gynecologist considered “a leading conservative Christian voice on women’s health and sexuality,” to the Advisory Committee for Reproductive Health Drugs in the Food and Drug Administration (FDA). In his position, Hager “played a key role” in convincing the FDA to overrule the advisory committee’s recommendations and to initially reject allowing emergency contraception, known as Plan B, from being made available over the counter. The American College of Obstetricians and Gynecologists called that decision a “dark stain on the reputation of an evidence-based agency like the FDA.” In Nov. 2006, Bush appointed Eric Keroack to the same position Orr plans to fill. Before the appointment, Keroack was the medical director at A Woman’s Concern, a Christian pregnancy counseling group that “supports sexual abstinence until marriage, opposes contraception and does not distribute information promoting birth control at its six centers in eastern Massachusetts.” In March 2007, Keroack resigned from the position to defend himself from accusations of medical fraud.

INTELLIGENCE — SENATE GRANTS IMMUNITY TO TELECOMMUNICATIONS COMPANIES ON WIRETAPPING: Yesterday, the Senate reached an agreement with the Bush administration on a government surveillance bill that includes immunity for telecommunications companies who may have broken the law in the past by making client data available to the National Security Agency. President Bush has declared immunity to be a precondition to his signing the bill. But providing immunity “would wipe out a series of pending lawsuits alleging violations of privacy rights by telecommunications companies that provided telephone records, summaries of e-mail traffic and other information to the government after Sept. 11, 2001, without receiving court warrants.” Cindy Cohn of the Electronic Frontier Foundation, the lead counsel in one such lawsuit against AT&T, said that these lawsuits are not the work of “typical trial lawyers trying to find a way to get into the pockets of American companies,” as House Minority Leader John Boehner (R-OH) claimed. “It’s certainly the goal of the administration and the phone companies to ensure that there’s never a decision about [whether] what’s been going on is legal or not. The telecom cases are the last, best hope,” Cohn said. The House Democratic leadership yesterday had to pull its version of the bill, which does not contain telecom immunity, after Deputy Whip Eric Cantor (R-VA) introduced an amendment that would have “substantially delayed” the legislation.

IMMIGRATION — WOMAN’S FAMILY ARRESTED AFTER SHE SPEAKS OUT ON IMMIGRATION REFORM: Last week, USA Today published an article in which Tam Tran, the daughter of a political refugee from Vietnam, described her family’s struggle to gain legal status in the United States. Three days later, immigration officers arrived at her home before dawn and took her entire family into custody. The arrests immediately raised eyebrows. Tran’s family was detained on a “years-old deportation order” and had been “reporting to immigration officials each year to obtain work permits.” Rep. Zoe Lofgren (D-CA), chairwoman of the House Immigration Subcommittee, “said she believes the family was targeted because Tran testified before Lofgren’s panel earlier this spring” in support of immigration reform. U.S. Immigration and Customs Enforcement (ICE) officials said that Tran’s testimony before Congress “absolutely, unequivocally had nothing to do” with her family’s arrest. But after being pressed on why a family in regular contact with immigration officials would be forcibly arrested in the middle of the night, Kelly Nantel, an ICE official, could only offer the excuse that agents “did not understand the complexity of the case.” Lofgren posed the question, “Would [Tran] and her family have been arrested if she hadn’t spoken out?”

Senate Minority Leader Mitch McConnell (R-KY) is still under the microscope from the Kentucky press over his office’s involvement in smearing Graeme Frost. In an editorial entitled “McConnell versus truth,” The Courier-Journal writes, “It’s clear what Mitch McConnell knew and when he knew it. It’s clear he deceived the public.”

“Under pressure to help override President Bush’s veto, at least five of the eight House Democrats who voted initially against expanding a popular children’s health insurance program now say they’ll switch sides.”

“The Pentagon is preparing to alert eight National Guard units that they should be ready to go to Iraq or Afghanistan beginning late next summer.” A National Guard official explained, “You create holes when you surge units forward, and someone has to fill them.”

The head of the Federal Communications Commission is pushing a plan to repeal a rule “that forbids a company to own both a newspaper and a television or radio station in the same city.” The plan would “be a big victory for some executives of media conglomerates,” including Rupert Murdoch.

“It is likely that Blackwater will not compete to keep the job” of escorting U.S. diplomats outside the protected Green Zone after May, according a U.S. official. “[T]here is a mutual feeling that the Sept. 16 shooting deaths mean the company cannot continue in its current role.”

“Alberto Gonzales was briefed extensively about a criminal leak investigation despite the fact that he had reason to believe that several individuals under investigation in the matter were potential witnesses against him in separate Justice Department inquiries.”

And finally: On election night 2006, eight-year old Sarah Maria Santorum wept on national television when her dad lost his Senate race. Country singer Martina McBride on Monday released a song, For These Times, inspired in part by the girl’s tears. “I always tell my children that good things come from bad things,” Rick Santorum said in an interview this week.

CHICAGO — An editorial May 2 in what is considered the Bible of the medical profession vindicates a researcher who told this newspaper months ago that mandating the human papillomavirus (HPV) vaccine for young girls is “a great big public health experiment.”

The vaccine, Gardasil, offers protection against four of the more than 100 known HPVs, two of which scientists believe cause about 70 percent of cervical cancers.

Last week, The Journal of the American Medical Association (JAMA) took a public stand against legislation to mandate this vaccine. The article, “Mandatory HPV Vaccination: Public Health vs. Private Wealth,” was co-authored by Chicago-based JAMA editor Dr. Catherine D. DeAngelis and Washington, D.C.’s Georgetown University professor Lawrence O. Gostin. Gostin specializes in public health law.

Declaring it unethical to rush into mandates, the authors accuse Gardasil’s manufacturer, Merck & Co., of putting profits ahead of the safety of the 2 million girls and women in the U.S. who, if it were mandated, would receive the vaccine before the long-term effectiveness and safety of it had been determined.

(This blog author believes there is a deeper evil than just money at work)

Pointing out that the Federal Drug Administration’s approval of the vaccine was conditional upon Merck agreeing to further test the safety and effectiveness of it, the JAMA article says, “Making the HPV vaccine mandatory contributes to long-standing parental concerns about the safety of school-based vaccinations.”

In fact, legislating the vaccine now “could have the unintended consequence of heightening parental and public apprehensions about (all) childhood vaccinations,” the article adds.

The article also questions how vaccine recipients would be compensated in the event of their suffering adverse effects from it, since some courts may determine that the manufacturer would not be liable if the states mandated it.

The article also admonishes Merck, which could rake in billions of dollars from a mandated vaccine, for financing efforts to persuade states and public officials to mandate it. “Private wealth should never trump public health,” the article says.

Vindicated

Until the JAMA article came out, Diane Harper, a physician, scientist and professor at Dartmouth University Medical School in New Hampshire, who spent 20 years studying the virus and helping to develop a vaccine for it, had stood virtually alone among her peers in denouncing efforts to mandate the vaccine.

When she first interviewed with this newspaper, she said she’d tried to convince major print and broadcast media to “tell the whole story” about the vaccine and why she, as a lead researcher on it, believes it is premature to mandate it.

“But no one would listen,” she said. She said she was speaking out with this newspaper because “it was the only one willing to listen to the whole story.”

Answering questions by e-mail, Gostin said he was aware of Harper’s concerns. (DeAngelis sent word through an aide that she was unavailable for an interview.) He and DeAngelis were motivated to write the editorial, Gostin said, because of the states’ rush to mandate the vaccine before all of the safety and effectiveness data were collected and analyzed.

In place of mandates, Gostin’s and DeAngelis’ JAMA article encourages public education about HPV and routine, voluntary vaccination as part of a comprehensive package aimed at preventing the infection. It also suggests that a young girl’s assent to being vaccinated is as essential as her parents’ consent.

“As for work with the states, it is important to stress that the vaccine is an important public health innovation, but it is necessary to move carefully and deliberately, taking a science-based approach,” Gostin said in his e-mail. “I think that mandatory vaccination has its place, but should be a last resort only if it is clear that it would be safe, effective and in the public’s interest. That standard has not yet been met with HPV vaccination.”

Relieved

Tuesday, Harper was at a national conference of gynecologists in San Diego when she learned of the JAMA article. Acknowledging that she’d experienced some backlash because of her views — but declining to go into specifics — Harper said she felt relieved and excited that a publication as prestigious as JAMA was basically vindicating her and validating her views.

“I’m glad we are starting to get clarification in our communications, and in understanding the details of points that need to be considered for this vaccination,” Harper said. “The Associated Press has consistently miswritten, and consistently reported information that was not accurate about HPV. I have gone to them in New Hampshire several times for corrections, and they did correct a couple of things, but the last time they were unresponsive.”

So many people had questioned her because of her non-politically-correct stance on the issue that there were times when it looked like even her research was being doubted, she said, which made her position even more troubling. However, she stood behind her convictions.

“There is a lot of colleagial pressure to conform to the message, and be united in the message,” she said. “But I think we are too early in our knowledge of information to have just one message.”

She reiterated that this is “a wonderful vaccine,” and that this is an exciting time for medicine in this area. Today, the New England Journal of Medicine (NEJM) is publishing some HPV articles that she co-authored, and that should help explain what this vaccine can and cannot do, she said.

“But there are things we still don’t know about this vaccine,” she said. “For one thing, it takes 129 women to be vaccinated to prevent one case of CIN 2/3 (a type of cervical cell dysplasia), and that is important for people to know. It will be interesting now that the JAMA article is out, and the NEJM articles about Gardasil are published, what the public understanding will be.”